A Low-Intensity Transcranial Focused Ultrasound Parameter Exploration Study of the Ventral Capsule/Ventral Striatum

Tina Chou; Brian J Kochanowski; Ashley Hayden; Benjamin M Borron; Miguel C Barbeiro; Junqian Xu; Joo-Won Kim; Xuefeng Zhang; Richard R Bouchard; Kinh Luan Phan; Wayne K Goodman; Darin D Dougherty

doi:10.1016/j.neurom.2024.03.004

A Low-Intensity Transcranial Focused Ultrasound Parameter Exploration Study of the Ventral Capsule/Ventral Striatum

Neuromodulation. 2024 Apr 29:S1094-7159(24)00067-9. doi: 10.1016/j.neurom.2024.03.004. Online ahead of print.

Authors

Affiliations

¹ Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA. Electronic address: tchou@mgh.harvard.edu.
² Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA.
³ Department of Radiology, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA.
⁴ Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA.
⁵ Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
⁶ Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus, OH, USA.

PMID: 38691076
DOI: 10.1016/j.neurom.2024.03.004

Abstract

Objectives: Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is effective for treatment-resistant obsessive-compulsive disorder (OCD); however, DBS is associated with neurosurgical risks. Transcranial focused ultrasound (tFUS) is a newer form of noninvasive (ie, nonsurgical) stimulation that can modulate deeper regions, such as the VC/VS. tFUS parameters have just begun to be studied and have often not been compared in the same participants. We explored the effects of three VC/VS tFUS protocols and an entorhinal cortex (ErC) tFUS session on the VC/VS and cortico-striato-thalamo-cortical circuit (CSTC) in healthy individuals for later application to patients with OCD.

Materials and methods: Twelve individuals participated in a total of 48 sessions of tFUS in this exploratory multisite, within-subject parameter study. We collected resting-state, reward task, and arterial spin-labeled (ASL) magnetic resonance imaging scans before and after ErC tFUS and three VC/VS tFUS sessions with different pulse repetition frequencies (PRFs), pulse widths (PWs), and duty cycles (DCs).

Results: VC/VS protocol A (PRF = 10 Hz, PW = 5 ms, 5% DC) was associated with increased putamen activation during a reward task (p = 0.003), and increased VC/VS resting-state functional connectivity (rsFC) with the anterior cingulate cortex (p = 0.022) and orbitofrontal cortex (p = 0.004). VC/VS protocol C (PRF = 125 Hz, PW = 4 ms, 50% DC) was associated with decreased VC/VS rsFC with the putamen (p = 0.017), and increased VC/VS rsFC with the globus pallidus (p = 0.008). VC/VS protocol B (PRF = 125 Hz, PW = 0.4 ms, 5% DC) was not associated with changes in task-related CSTC activation or rsFC. None of the protocols affected CSTC ASL perfusion.

Conclusions: This study began to explore the multidimensional parameter space of an emerging form of noninvasive brain stimulation, tFUS. Our preliminary findings in a small sample suggest that VC/VS tFUS should continue to be investigated for future noninvasive treatment of OCD.

Keywords: Cortico-striato-thalamo-cortical circuit; obsessive-compulsive disorder; reward; transcranial focused ultrasound; ventral striatum.